| NPI | 1487053336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A161461) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 284415) |
| 207P00000X Emergency Medicine (Licence: WI 84378) | |
| Enumeration Date | 2014-08-16 |
| Last Update Date | 2025-09-22 |